BB Guns Research Articles

Surgical intervention for traumatic cataracts in children: Epidemiology, complications, and outcomes

To describe the presentation, treatment, and outcomes of a series of patients with unilateral traumatic cataracts. Retrospective, noncomparative review of 25 consecutive children with unilateral traumatic cataracts managed at a single institution during a 5-year period with regard to demographic data, mode of injury, clinical course, and outcome. Paintball and BB gun injuries were the most common mode of injury, accounting for 28% of all cases, followed by injury from pens and pencils (16%). Preoperative visual acuity was poor in 19 patients (76%), and final postoperative visual acuity was poor (20/200 or worse) in 4 patients (16%); this difference was statistically significant (p < 0.001). Twenty-one percent of children with poor vision on initial examination had poor vision at their final examination, and no patients with vision better than 20/200 on initial examination developed poor vision postoperatively (p = 0.29). Patients who developed poor final vision were younger on average than those who achieved satisfactory vision (5.25 years vs 7.5 years). Poor visual outcome did not appear to depend on the time from injury to presentation and time interval between injury and cataract extraction. Children with visually significant traumatic cataracts can have good outcomes if they are managed aggressively and appropriately. In our patient population, paintballs and BB guns accounted for more than 25% of traumatic cataract injuries, and a large number of traumatic cataracts were sustained by pens and pencils.

A Case of a BB-gun Pellet Injury to the Ethmoid Sinus in a Child

Injuries caused by BB and pellet guns remain common among children. These guns fire low-velocity missiles that can cause considerable harm when fired at close range. Most injuries occur in adolescents as a result of accidental or careless shooting. Such injuries to head and neck sites are common, second only to injuries to the extremities. We report the case of a 10-year-old girl who was accidentally shot by a BB gun. The BB pierced the skin of her right cheek, traversed the right maxillary sinus walls, and lodged at the junction of the right ethmoid sinus and septum. Preoperative radiology combined with endoscopic surgery techniques and instrumentation allowed us to precisely locate and remove the steel ball from the paranasal sinus while the patient was under general anesthesia. We review the scope of maxillofacial injuries caused by BB and pellet guns, and we discuss their presentation, diagnosis, and management. Although these guns are easily bought and sold as toys, they are weapons capable of causing significant injury.

Incidence and circumstances of nonfatal firearm-related injuries among children and adolescents.

To describe the incidence and circumstances of nonfatal firearm-related injuries among children and adolescents treated in US emergency departments. Data were obtained from the Firearm Injury Surveillance Study, 1993-1997; data were collected through medical record review at hospitals participating in the National Electronic Injury Surveillance System. The hospitals participating in National Electronic Injury Surveillance System are a stratified probability sample of all US hospitals. Numbers and population rates for nonfatal firearm-related injuries among children and adolescents younger than 20 years old. An estimated 115,131 (95% confidence interval, 76,769-153,493) children and adolescents were treated for a nonfatal gunshot wound during the study period. The estimated annual rates of injury (per 100,000) were 2.0 (children 0-4 years old), 2.2 (children 5-9 years old), 15.4 (children 10-14 years old), and 106.5 (adolescents 15-19 years old). The ratios of nonfatal to fatal firearm-related injuries were 4.0 (children 0-4 years old), 4.4 (children 5-9 years old), 5.0 (children 10-14 years old), and 4.4 (adolescents 15-19 years old). An additional estimated 103,814 children (95% confidence interval, 69,223-138,405) were shot with a nonpowder firearm (BB or pellet gun). Boys 5 to 9 and 10 to 14 years old had the highest rates of injury related to nonpowder firearms, an estimated 36.2 and 99.8 per 100,000, respectively. Fifty-six percent of those 15 to 19 years old were assault victims. An estimated 48% of children and adolescents with powder firearm-related gunshot wounds and an estimated 4% with nonpowder firearm injuries were admitted to the hospital. Nonfatal injuries related to powder firearms and nonpowder firearms (BB or pellet guns) are an important source of injury among US children and adolescents. Ongoing surveillance of nonfatal firearm-related injury among children and adolescents is needed.

Life-threatening air rifle injuries to the heart in three boys

Air rifles, or BB guns, are generally thought of as childhood toys. Although most injuries are not serious, life-threatening events have been reported. Within a 1-year period, 3 boys presented after BB gun shots to the chest, all requiring surgical intervention for penetrating injuries to the heart. A 15-year-old underwent window pericardiotomy for hemopericardium with thrombus 24 hours after admission. Another, 5 years of age, underwent emergent exclusion of the cardiac apex for a traumatic ventricular septal defect. The third, 8 years old, had a right ventricular injury requiring an urgent subxiphoid pericardial window for tamponade. All recovered uneventfully. Increased public awareness, adult supervision, safety training, and appropriate legislation are needed to decrease the risks of these potentially lethal weapons. J Pediatr Surg 35:785-787. Copyright © 2000 by W.B. Saunders Company.

Injuries related to BB and pellet guns

Injuries related to BB and pellet guns

The Ongoing Hazard of BB and Pellet Gun-Related Injuries in the United States

Study objective: To characterize BB and pellet gun-related injuries treated in US hospital emergency departments. Design: We obtained data through the National Electronic Injury Surveillance System of the US Consumer Product Safety Commission and weighted them to obtain national estimates. Results: We estimate that from June 1, 1992, through May 31, 1993, 32,997 (95% confidence interval [CI], 27,823 to 38,171) people or 12.9 per 100,000 population (95% CI, 10.9 to 14.9) were treated for BB and pellet gun-related injuries. Of this total, 96% (31,547 [95% CI, 26,600 to 36,494]; 12.3 per 100,000 population [95% CI, 10.4 to 14.2]) sustained gunshot wounds. The incidence of BB and pellet gunshot wounds was highest among males (21.0 per 100,000 population [95% CI, 17.7 to 24.3]), children aged 10 through 14 years (71.4 per 100,000 population [95% CI, 57.4 to 85.4]), and blacks (14.6 per 100,000 population [95% CI, 10.3 to 18.9]). Boys aged 10 through 14 years had the highest risk of injury (121.1 per 100,000 population [95% CI, 95.0 to 147.2]). Although most patients (62%) were victims of unintentional shootings, 13.7% were victims of assault. Males aged 10 through 24 years (49.1% of assault cases) had the greatest risk of assault-related BB and pellet gunshot wounds. Conclusion: BB and pellet gunshot injuries continue to represent a substantial public health problem, especially to children and adolescents. Although BB and pellet guns are designed and intended for recreational use and competitive sport, they are sometimes used to inflict harm, most often among teenagers aged 15 through 19 years. Intervention strategies must be developed and implemented to reduce unintentional shootings and assaults associated with BB and pellet guns. [McNeill AM, Annest JL: The ongoing hazard of BB and pellet gun-related injuries in the United States. Ann Emerg Med August 1995;26:187-194.]

Penetrating Abdominal Air Gun Injuries: Pitfalls in Recognition and Management

Emergency health care providers often underestimate the potential for pellet and BB guns to inflict life-threatening penetrating injuries. We present four children with intraabdominal injuries caused by air guns and summarize the characteristics of 12 similar cases reported in the literature. In the context of injury potential, the epidemiology of air gun injuries and the mechanical characteristics of air guns are reviewed. In addition, we suggest a general approach to the triage and management of children with air guninflicted abdominal wounds. Finally, preventive strategies are discussed. [DiGiulio GA, Kulik RM, Garcia VF: Penetrating abdominal air gun injuries: Pitfalls in recognition and management. Ann Emerg Med August 1995;26:224-228.]

It may be more significant than you think: BB air rifle injury to a child??s head

BB guns of 20 years ago were constructed of coils and springs which generated relatively little force, so that a projectile posed little threat of serious injury. Today, the coil and spring construction has been replaced by pump action pneumatic chambers which allow generation of muzzle velocities near 350 ft/sec. Speeds of 150 ft/sec and 200 ft/sec are required for skin penetration and bone penetration, respectively. We present a seven-year-old boy who suffered intracranial parenchymal injury from an air-powered BB gun projectile while playing with friends. We discuss literature which suggests these once-innocent toys are now harbingers of severe, if not fatal, injury.

Epidemiology of Severe Eye Injuries in Childhood

The authors conducted a cross-sectional study of all ocular injury cases admitted to a children's hospital between January 1978 and December 1984. Of 222 injuries reviewed, 77 (35%) resulted in some visual deficit. Males were significantly overrepresented in all age groups with an average male:female ratio of 3.5:1. The distribution of injuries was: contusions, 114 (51 %); penetrating lacerations, 62 (28%); foreign bodies and burns, 11 (5%); and nonpenetrating lacerations, 35 (16%). Sixteen (7%) ocular injuries were associated with BB gun pellets and six of these children (42%) were blinded in the injured eye as a result. Two other cases of blindness resulted from ocular penetration by homemade “Jinsang Stars,” underscoring the adverse influence of media on children's games. Adult supervision could have potentially prevented most cases of permanent visual deficit. The authors suggest that legislation restricting the use of BB guns be passed and that a program of adult and child eye safety education including “eye watch” warnings on potentially hazardous toys be developed.

BB and pellet guns: Toys or deadly weapons: W. Harris, A. Luterman, and P.W. Curreri. J Trauma 23:566–569, (July), 1983

BB and pellet guns: Toys or deadly weapons: W. Harris, A. Luterman, and P.W. Curreri. J Trauma 23:566–569, (July), 1983

Experiments on the penetration power of various bullets into skin and muscle tissue.

The literature cites values between approx. 50 to as critical velocities for spherical or ogival projectiles. This test was designed to determine the general validity of these values. “Critical velocity” is defined as that velocity, below which no penetration of the skin occurs. A series of 212 test shots was fired after the powder storage chambers of caliber 9 mm and caliber .45 cartridge cases were altered. With the appropriate charges, velocities varying between 50 and 100 m per sec were achieved. The shots were fired orthogonally into the muscle tissue of the upper thigh of corpses and into a combination of human skin + Mipoplast®. The skin was tightened in a wooden frame and a block of Mipoplast® was directly attached. (Preliminary tests showed that projectiles nearly had the same penetration power in Mipoplast® as in muscle tissue.) The projectile velocities were determined by a „shoot-velociter Re-Tronik“ with a resolving power of 10−6 sec. Projectiles were considered as having penetrated the skin, when they entered the epidermis for a distance equal to the caliber diameter. In order to determine a ballistic coefficient and a conversion factor, the depth of penetration into muscle tissue of the upper thigh or into Mipoplast® respectively was measured. The following bullets were used in the tests: 9 mm :lead ball 5.3 g lead, round nose projectile with a short cylindrical portion, 6.2 g lead, round nose projectile with a long cylindrical portion, 10.6 g conical, flat nose projectile 7.9 g conical, pointed nose projectile 7.9 g caliber. 45 : lead ball 9 g lead, round nose with a cylindrical portion, 14.7 g and finally a 4 nun lead ball. 47 g. The projectiles were fired from a Walther pistol P 38, caliber 9 mm Parabellum, a colt pistol, Government 1911 A1, caliber .45 ACP and from a revolver Röhm RG caliber 4 mm Rdz. The tests results permit three functional evaluations per series: (1) optimum parabola of second order, (2) optimum line (linear regression), (3) logarithmic function (log. nat.) The following results were obtained: The penetration power of a projectile does not depend primarily on its velocity, shape or cross-sectional load, but is determined by its mass. The following conclusions could be drawn, concerning lead projectiles fired by us: The greater the mass of a projectile, the lower the „critical velocity“ (vcr = 162.1 • e−629 m) The conversion factor for the penetration power of the examined projectiles comparing skin/Mipoplast® and skin/muscle tissue was determined to be 1.2, i. e. the depth of penetration into skin and muscle tissue is 1.2 times greater than into skin + Mipoplast ®. An evaluation of these results shows a “loop-hole” in the Gun Control Act, since the legal requirements for the unrestricted acquisition of firearms only considers the kinetic energy of the projectile (less than 7.5 J). However, all lead ball ammunition with diameters of less than 6.2 mm definitely does penetrate the skin at that energy level. Another conclusion is that projectiles fired from unlicensed weapons such as BB guns operated by air pressure, spring or CO2-cartridge (caliber approx. 4.5 mm) can achieve penetration with as little energy as 4 J. Even if one wants to maintain the present differentiation between exempted weapons and weapons covered by the Gun Control Act, based on the energy level of 7.5 J, the legislature would have to establish a minimum mass for the projectiles. Considering the results obtained, the present limitation of the kinetic energy of the projectiles of 7.5 J alone does not guarantee the level of harmlessness the present law supposes. A projectile mass of less than 1.4 g and a kinetic energy of 7.5 J can reach a level of danger that up now has not been recognized by the legislature. Those findings ought to be considered when licensing weapons according to Para 21 and 25 WaffG (Gun Control Act of the Federal Republic of Germany) as well when prohibiting weapons according to Para 37 WaffG and Para 8, Section 1, Number 1, of the first WaffV (Weapon Regulations).

Penetrating ocular injury by a plant seed.

BB GUNS have long been recognized as an important cause of ocular injury, the offending missile usually being a 4.4 mm copper-coated steel sphere.1,2Our young patient was struck in the eye by a plant seed fired from a bb gun. The seed perforated the limbus and adjacent sclera and remained intact in the vitreous cavity. The unusual nature of this foreign body and the fulminating bacterial panophthalmitis that followed its penetration are the principal features of this report. Report of a Case A 9-year-old Navajo Indian boy was seen at the Gallup Indian Medical Center, Gallup, NM, seven hours after being shot accidentally in the left eye with a bb gun fired from a distance of six feet. The rest of his medical history was unrelated to his ocular problem. The general physical examination was within normal limits. The hemoglobin level was 12.8 gm/100 cc, and the white